US internal medicine physician moving to Australia

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Aizee

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Hey guys
Australian system seems really confusing from here. I need some help. So far i understand that i can apply for competent authority pathway. I have multiple questions. Please help if you know the answers to any of them

1) Does internal medicine residency(3 year residency program in US) qualify me for specialist pathway? Is it equal to general medicine? Because we only do adult medicine and have little or no experience in OBGYN and peds. I know family medicine in US does take care of such people.

2) Will I have to take PESCI if I apply for specialist pathway?

3) Do i need to look for a job first and then apply for specialist pathway?

4) Do i need to look for a job first and then apply for registration in case I am going for competent authority pathway

5) My husband and I have applied for work visa (through his work) and if we get the visa, is it wise to apply after we have visa or does it not matter

6) I will finish my residency next year in June. I have done >2 years. Can I still apply for specialist pathway.

I have more questions. But just posting these for now.

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1) Does internal medicine residency(3 year residency program in US) qualify me for specialist pathway? Is it equal to general medicine? Because we only do adult medicine and have little or no experience in OBGYN and peds. I know family medicine in US does take care of such people.

I'd suggest asking the Royal College of Physicians directly. [email protected]
Rather than asking randoms on the internet.

Have you tried visiting the Royal college of physicians website?
In particular, refer to the one directed towards overseas trained physicians: Overseas trained physicians and paediatricians in Australia

Internal medicine is called "basic physician's training" in Australia. It is also 3 years in length.
however, after you do the "internal medicine exit exams" in your 3rd/final year in Australia, you still have to do 3 years of additional advance training in internal medicine. Then do more exit exams. Then you're able to call yourself an attending or consultant. Or apply for fellowship for further training, to boost the CV, before working as an 'attending'. Internal medicine in Australia applies to only adult medicine.

Pediatrics and OBGYN are their own respective specialties, with different requirements.
Family med in Australia does involve peds and OBGYN to a degree.

2) Will I have to take PESCI if I apply for specialist pathway?
For everyone's reference, a PESCI is: RACGP - Pre-Employment Structured Clinical Interview (PESCI).
Answer: I don't know. Have you asked AHPRA? What was their answer?

3) Do i need to look for a job first and then apply for specialist pathway?
I would highly recommend you thoroughly read CP's thread: US doctor moving to Australia.
And the official source: Medical Board of Australia - Specialist pathway - specialist recognition.
Also go through this part of the AHPRA website: Medical Board of Australia - Guides and reports
You can work under provisional registration in the interim (I believe), and wait for a specialist royal college to assess your credentials to determine if you can work as a specialist.
But you cannot work as a specialist until the relevant royal college reviews your credentials and determines if it is equivalent to Australian training.

I don't know if you need a job per se in order to apply for specialist training.
have you tried asking AHPRA?

4) Do i need to look for a job first and then apply for registration in case I am going for competent authority pathway
You can apply for registration first. You don't have to have a job to apply for registration.
I would suggest you get registration asap if you qualify. Easier for hospitals to hire you, because you'd be able to work straightaway. No registration means you'll be delayed from starting work until you do. You legally cannot work without registration.

5) My husband and I have applied for work visa (through his work) and if we get the visa, is it wise to apply after we have visa or does it not matter
It's always better to have a VISA first. Many hospitals prefer this. It means you can start work pretty quickly. Otherwise, it's potentially a long process, even if you find a hospital that will sponsor you. Even the odd UK grad are starting to struggle to get a VISA in time to start work nowadays. Not all, but some.

6) I will finish my residency next year in June. I have done >2 years. Can I still apply for specialist pathway.
Residency in what? Internal medicine?
As above. Ask the royal college of physicians.
I'm not an IMG. So I'm not really sure what happens when you apply to these pathways or what's involved. I do know that it can take months, like 9 months, for a college to determine if your previous training is equivalent to Australian training. It doesn't mean the outcome will be in your favor either. Even the website quotes that. Outcomes could be - 1) they find it's non-equivalent and you have to start residency from scratch all over again (less likely if you've completed training in the US), 2) mostly equivalent, but will ask you to do 1-3 more years of additional training/'residency', 3) find it equivalent and you're ready to apply for attending jobs.

Even if you get specialist recognition, it's not easy to find attending jobs in the cities presently.

Very, very likely, you will have to work rural at least for a couple of years. To work in the cities it's about research and connections, very generally speaking. It's hard for even domestic Australians to remain at large metro hospitals. Many are now doing PhDs, or trying to pick up fellowships overseas to boost their CVs. It's competitive now. If your husband's job requires him to be in a city, you may have to make some compromises.
 
1) this is a tricky question, as IM in the US is considered a 'primary care' specialty, as opposed to Australia where GPs are the only primary care doctors. I was reading somewhere that an IM residency is equivalent to basic physician training in Australia, rather than an FRACP general physician. This sounds about right as training time is similar, and the I've heard difficulty of the board exams vs bpt exams are pretty similar (?). I'm not a physician so I wouldn't know. No one can become a specialist after completion of BPT, you have to move onto RACP advanced training (fellowship equivalent). In Australia, everyone, including general physicians have to do advanced training on top of BPT to get the FRACP.

Based on anecdotal evidence, the only way you would be comparable to an Australian FRACP is by completing an IM fellowship. I know a consultant cardiologist in my hospital who was a board certified cardiologist for >10 years, and got his FRACP in about 2-3 years after arriving here. Its definitely not easy.

Then again, specialist assessment is done on a case-by-case basis by looking not only at your qualification, but experience and clinical skills too. But if you would be fresh out of residency, I wouldn't guarantee it.

2) PESCI is usually for area of need positions for GPs - not for internal medicine specialists like yourself. You are looking for the 'RACP OTD specialist pathway'

3) Applying for the specialist pathway takes ages (many months), and thats if everything goes smoothly. So as far as I know, you look for a job after you pass the assessment. Passing the assessment allows you to gain 'limited registration' where you work at a senior registrar (resident using US language) before they deem you fit to sit the FRACP fellowship exams.

For the area of need pathway (AON) however, you will need to secure a job first. The AON pathway is the other route to fellowship/specialist registration for IMGs. Then after receiving the job offer, you apply to the RACP. In the AON pathway, the RACP matches your suitability by matching your skills to the specific job description; as opposed to the specialist pathway, where they determine your suitablity by comparing your US training to an Australian trained specialist (FRACP curriculum). After working in the AON pathway for a indeterminate period of time, you are able to sit the FRACP fellowship exams. I am pretty sure the timeframe to fellowship through AON is usually longer (3+ years)

4) I think you can go for a job either before or after, doesn't really matter. Thousands of doctors (particularly UK docs) come in this way. Even if you aren't eligible through specialist pathway, I know for certain you are definitely eligible for competent authority. There are plenty of recruitment companies that can help you with this, and the process is much easier than the specialist pathway.

5) i have no idea about visas, but having a visa is always better than not having one!

6) you will only be eligible for the specialist pathway if you are registered as a specialist in your home country. If you come to Australia before you finish your residency, you can only gain registration through competent authority.

BTW, the above advice is purely anecdotal, but hopefully you find it helpful. Good luck!
 
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So in the US you graduate medical school and do 3 years of IM residency and are fully trained then to work as an IM attending but in Australia you do 3 years of BPT training after a few house officer resident years and then another 3 years of RACP training before being qualified to work as a fully trained IM consultant ?

Interesting. I wonder why the training matches up so differently?
 
So in the US you graduate medical school and do 3 years of IM residency and are fully trained then to work as an IM attending but in Australia you do 3 years of BPT training after a few house officer resident years and then another 3 years of RACP training before being qualified to work as a fully trained IM consultant ?

Interesting. I wonder why the training matches up so differently?

Pretty much. In Australia, the amount of time and training needed to become an IM attending is the same as a subspecialist attending. I guess the system is just different. Primary care IM's do a lot of what GP's would do here.
 
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Hours are significantly less per year worked during training. They make it up by extending the duration of training in years.
 
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Hey guys
Australian system seems really confusing from here. I need some help. So far i understand that i can apply for competent authority pathway. I have multiple questions. Please help if you know the answers to any of them

1) Does internal medicine residency(3 year residency program in US) qualify me for specialist pathway? Is it equal to general medicine? Because we only do adult medicine and have little or no experience in OBGYN and peds. I know family medicine in US does take care of such people.

2) Will I have to take PESCI if I apply for specialist pathway?

3) Do i need to look for a job first and then apply for specialist pathway?

4) Do i need to look for a job first and then apply for registration in case I am going for competent authority pathway

5) My husband and I have applied for work visa (through his work) and if we get the visa, is it wise to apply after we have visa or does it not matter

6) I will finish my residency next year in June. I have done >2 years. Can I still apply for specialist pathway.

I have more questions. But just posting these for now.
Did you every figure out if you qualified for the specialist pathway after completing IM residency in US?
 
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